HB 62-FN - AS INTRODUCED
2021 SESSION
21-0010
10/05
HOUSE BILL 62-FN
AN ACT relative to continued in-network access to certain health care providers.
SPONSORS: Rep. Marsh, Carr. 8; Rep. Nelson, Carr. 5; Rep. Crawford, Carr. 4; Rep.
MacDonald, Carr. 6; Rep. Weston, Graf. 8; Sen. Rosenwald, Dist 13; Sen. Bradley,
Dist 3
COMMITTEE: Commerce and Consumer Affairs
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ANALYSIS
This bill requires access by a covered person to a provider in the insurer's provider directory at
in-network rates for the duration of the contract for health care services.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
 HB 62-FN - AS INTRODUCED
21-0010
10/05
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty One
AN ACT relative to continued in-network access to certain health care providers.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 1 Managed Care; Continued Access. Amend RSA 420-J:7-d to read as follows:
2 420-J:7-d Continued Access to Care Subsequent to a Provider Contract Termination.
3 I. The commissioner may extend the period of continued access to care subsequent to a
4 provider contract termination provided for under RSA 420-J:8, XI for up to an additional 60-day
5 period.
6 II. When an insurer's provider directory includes a provider as a participating
7 provider for a network at such time as a prospective covered person selects his or her
8 health benefit plan, such insurer shall cover the provider charges at in-network rates for
9 the duration of the contract period for such covered person, regardless of whether such
10 provider remains a participating provider in the insurer's network, and shall ensure that
11 the covered person shall not be responsible for more than the amount for which he or she
12 would have been responsible had the services been delivered by an in-network provider
13 under the network managed care plan.
14 III. Paragraph II shall not apply if the provider:
15 (a) Becomes out-of-network due to suspension, expiration, or revocation of the
16 provider's license; or
17 (b) Unilaterally terminates participation in the insurer's network for reasons
18 other than default or breach by the insurer of a contract with the provider for the provision
19 of health care services.
20 2 Effective Date. This act shall take effect January 1, 2022.
 LBA
21-0010
11/13/20
HB 62-FN- FISCAL NOTE
AS INTRODUCED
AN ACT relative to continued in-network access to certain health care providers.
FISCAL IMPACT: [ X ] State [ X ] County [ X ] Local [ ] None
Estimated Increase / (Decrease)
STATE: FY 2021 FY 2022 FY 2023 FY 2024
Appropriation $0 $0 $0 $0
Revenue $0 Indeterminable Indeterminable Indeterminable
Expenditures $0 $0 $0 $0
Funding Source: [ X ] General [ ] Education [ ] Highway [ ] Other
COUNTY:
Revenue $0 $0 $0 $0
Expenditures $0 Indeterminable Indeterminable Indeterminable
LOCAL:
Revenue $0 $0 $0 $0
Expenditures $0 Indeterminable Indeterminable Indeterminable
METHODOLOGY:
This bill requires access by a covered person to a provider in the insurer's provider directory at
in-network rates for the duration of the contract for health care services.
The Insurance Department indicates this bill would require insurers to provide coverage for out-
of-network providers, who were in-network providers at the time the covered person enrolled, at
in-network rates for the duration of the covered person’s contract. With limited exceptions, the
insurer would ensure that the covered person’s out of pocket liability not exceed the amount the
person would have been responsible for if the provider had remained in-network. The
Department assumes the bill would only impact the covered person’s out-of-pocket liability and
the bill would not force providers to accept reimbursement at previously negotiated rates from
when the provider was in-network. The Department indicates the bill would cause inflationary
pressure on claims as more claims would be considered allowed, when such claims wouldn’t have
been covered for a person seeking services from an out-of-network provider. The Department
assumes the cost for service would be greater for the new out-of-network provider resulting in
inflationary pressure on the amount paid. Inflationary pressures on claim costs may result in
increased premium rates or benefit re-designs. Purchasers may respond by either paying the
 increased rates or by buying down. These effects may have a small impact on premium tax
revenue collected by the State.
The Department of Health and Human Services indicates this bill would apply to commercial
carriers and not to the Medicaid program and would not impact State Medicaid expenditures.
To the extent political subdivisions purchase health insurance through a managed care
insurance plan, there may be an impact on county and local expenditures.
AGENCIES CONTACTED:
Departments of Insurance and Health and Human Services


Statutes affected:
Introduced: 420-J:7-d
latest version: 420-J:7-d